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PubMed1995

[Sexual development in urban and rural girls].

By means of interviews the sexual development of 16 to 18-year-old Czech girls was investigated: 163 lived in rural communities with less than 2,000 inhabitants and 271 lived in towns with more than 100,000 inhabitants. Comparison of these two groups, using Schofield's diagram, revealed that the difference in the course of sexual development was not statistically significant. However, when individual items of the examination were analyzed, significant differences were found in the education of probands and both their parents, education being higher in the group of urban girls. In urban girls the prevalence of broken marriages of their parents was also higher, the loss of the father before the child was 18 years was more frequent and the number of siblings was smaller. The age at the first sexual intercourse was lower in urban girls and they had more frequent experience with cunnilingus and fellatio.

Adolescent↗
PubMed1987

[Internal migration in developing countries: rationality of rural-urban migration].

"In many developing countries there is a positive and nondecreasing rural-urban net migration. As a rule, making migration decisions jointly is advantageous for individual potential migrants and their families. Rationality of migration decisions depends on the specific character of the constituents of the basic decision model. In most cases, individual or family rationality of migration does not coincide with collective rationality. Trying to bring the two together requires trying to improve the coordinative function of main economic variables and trying to improve the decision makers' information." (SUMMARY IN ENG)

Behavior↗
PubMed1997

Challenges in defining and developing the field of rural mental disorder preventive intervention research.

An overview of selected issues and challenges in defining and developing the field of rural preventive intervention research is presented. One fundamental challenge is to clarify the distinguishing characteristics of prevention science in rural contexts. Other challenges are evident in the need to address: the lack of consensus on conceptual and methodological approaches to this field, limited empirical study to date, the tremendous diversity of rural populations, and inconsistencies in the usage of the term "rural". This article suggests the organization of a work group to formulate and implement a clear research agenda. In addition, several general questions are discussed that, if addressed, might serve to better define and further develop the field. These questions concern the implications of multiple approaches to prevention science in rural contexts, the classification of rural populations, the functional relevance of rural residence in the etiology of specific disorders, the application of extant etiological models to interventions designed specifically for rural populations, the conduct of rural area prevention needs assessments, the development of models for collaboration between intervention researchers and rural community stakeholders, and strategies to engage rural residents in preventive interventions.

Community Mental Health Services↗
PubMedDate not supplied

Cluster analysis of psychogeriatric characteristics and service use among rural elders.

In developing models of psychiatric service delivery, nurses must be able to target groups on the basis of their health status and service needs. This investigation attempted to develop profiles of rural elderly, a significant risk population, by subjecting data on the psychogeriatric nursing status and health services utilization of 125 subjects to cluster-analytic methods. The cluster analysis yielded a three-cluster model: Cluster 1 (n = 39) predominantly comprised unmarried women in moderate health, but with a high degree of health service utilization; Cluster 2 (n = 53) had rural elders with moderate physical impairments, self-perceptions of poor health, and moderate health service utilization; and Cluster 3 (n = 33) comprised elders with severe cognitive and physical impairments and high health service utilization. Cluster 2 subjects were judged to be mild users of services because they were younger and married without a regular source of health care. Because subjects in Cluster 1 tended to be unmarried women who lived alone, with mild to moderate physical impairments and a regular source of health care, these subjects were assessed as moderate users of services. Cluster 3, which comprised the oldest and most impaired, both physically and cognitively, were judged to be intensive users of services.

Activities of Daily Living↗
PubMedDate not supplied

Women's reality: critical issues for program design.

The following article looks at social controls on the behavior of rural women in Bangladesh that need to be considered in project designs if women are to be able to respond to development programs. Rural women in many countries are constrained by analogous social pressures, which usually have an economic basis favoring the more powerful and therefore are resistant to change. Since these pressures on rural women often have a negative effect on the goals of rural development, they need to be understood and addressed.

Adult↗
PubMedDate not supplied

Infant and child mortality in the rural areas of the developing world: a review of recent trends and policy implications.

"The paper reviews the existing data on recent trends in infant and child mortality rates in the rural areas of the developing world. Data sources include vital registration (when available), estimates of mortality on the basis of surveys (Brass method), and prospective ad hoc studies." A comparison of mortality data for 31 developing countries indicates that rural mortality is nearly always higher than that in urban areas. Factors associated with higher rural mortality are analyzed, including patterns of family formation, nutrition, fertility, and infectious diseases. Consideration is also given to the effects of discrimination against female infants in certain cultural settings and to the importance of education for women. (summary in FRE, ITA)

Behavior↗
PubMed1992

An intelligent computer-assisted instruction system designed for rural health workers in developing countries.

This paper describes an intelligent computer-assisted instruction system that was designed for rural health workers in developing countries. This system, called Consult-EAO, includes an expert module and a coaching module. The expert module, which is derived from the knowledge-based decision support system Tropicaid, covers most of medical practice in developing countries. It allows for the creation of outpatient simulations without the help of a teacher. The student may practice his knowledge by solving problems with these simulations. The system gives some initial facts and controls the simulation during the session by guiding the student toward the most efficient decisions. All student answers are analyzed and, if necessary, criticized. The messages are adapted to the situation due to the pedagogical rules of the coaching module. This system runs on PC-compatible computer.

Computer Simulation↗
PubMed1989

The impact of China's rural industrialization upon the urbanization of population and its theoretical significance.

The author examines the impact of industrialization on urbanization and the rural structure in China. "The development of rural industries and industrialization of rural areas are the most feasible and effective ways to help in the transference of rural population and...urbanization. The growth of rural industries will help expand and re-direct rural labor from agricultural resources to non-agricultural resources, to the processing of farm produce and by-products, to pre- and pro-production services for agriculture and to cooperation with urban industries... The results will include the expansion of laboring fields, a more elaborate social division of labor, changes in social, economic and employment structures as well as an increase in employment opportunities...."

Asia↗
PubMedDate not supplied

Rural migration and regional development: the example of Indonesia.

"Regional disequilibria in the distribution of population lead in many developing countries to migration flows which cannot always be equated with flight from the land or drift to the cities. In diverse countries rural-rural migration is even supported by the state. This rural migration leaves a decisive mark not only on the regional development of the areas from which emigration takes place but also on the absorbing areas. The following article examines the costs and benefits for both [using the example of Indonesia]."

Asia↗
PubMed1991

A Canadian model for developing mental health services in rural communities through linkages with urban centers.

The development of mental health care services in rural areas has been a constant challenge in most countries of significant geographical size. By use of a case study from Canada, the development of a relationship between rural and urban mental health services was described. Issues including referral patterns, service accessibility, professional recruitment and the development of service in rural regions were studied. It is advanced that mental health administrators, policy-makers, clinical service coordinators and educators will find that this approach to the development of mental health services in rural areas has some utility in Canada and in other countries.

Canada↗
PubMed1981

An analytic method for the evaluation of rural Emergency Medical Service development.

An analytic method is presented for assessing the marginal impact of incremental changes in rural Emergency Medical Services (EMS) on cardiac mortality, morbidity, EMS system process and performance, and health care system utilization. The method incorporates a model of the EMS system. This model specifies five sets of interactive variables characterizing EMS system development and effectiveness. The analytic method quantifies the contribution of each of these sets of interactive variables on the outcome variables (cardiac mortality, morbidity, EMS process/performance, and health care system utilization) for three target populations: those who utilize the EMS system, all hospitalized patients with acute ischemic heart disease independent of EMS system use, and the population of all patients dying from acute ischemic heart disease on a communitywide basis. By including in the model those factors unique to rural areas, such as scarcity of fiscal and health care system resources, geographical constraints, and the skewed severity of case mix due to the clinical and socioeconomic conditions found among rural patients, the analytic method is able to quantify and help explain the impact of these factors on the EMS system and the limitations which they impose. The analytic method affords planners and administrators and rational basis for decisions regarding future rural EMS system development through its identification of those system characteristics amenable to change and worth pursuing from a health policy perspective.

Coronary Disease↗
PubMed2003

Evaluation of a child development centre in a rural area.

In this article we discuss the setting up of a child development centre for children with a developmental delay in a rural market town away from a tertiary centre. The process was evaluated by a variety of methods including analysis of centre activity, preliminary questionnaires to parents at the end of their child's assessment, reflections by the centre team and in the final year of the project, a survey of all parents who had used the service, professionals who worked in it and other agencies in the centre town and a comparison town. Parents and staff reported high levels of satisfaction in relation to multidisciplinary working, venue, communication, and a child/family friendly approach. Further work is needed in developing links with social services and the voluntary sector.

Child↗
PubMed1997

A fellowship in rural family medicine: program development and outcomes.

BACKGROUND AND OBJECTIVES: Many strategies have been used by academic institutions to address the shortage of rural family physicians. Fellowship training in rural family medicine represents one approach. METHODS: Tacoma Family Medicine developed a fellowship program of this type. Five years of operations are described, including applicants, educational outcomes, rural outcomes, and adverse outcomes. RESULTS: An adequate applicant pool does exist, composed of both applicants from residency and from practice. A curriculum of advanced obstetrics, electives, and a rural experience has been successful. Unforeseen problems included a strained relationship with family practice residents in the program and competition for community preceptors. CONCLUSIONS: Family practice residencies with a mission of rural training are encouraged to consider the strategy of a rural fellowship.

Curriculum↗